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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 157203395
Report Date: 07/27/2023
Date Signed: 07/27/2023 02:50:54 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/31/2023 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230131153349
FACILITY NAME:BROOKDALE RIVERWALKFACILITY NUMBER:
157203395
ADMINISTRATOR:WEBSTER, REGFACILITY TYPE:
741
ADDRESS:350 CALLOWAY DRTELEPHONE:
(661) 587-0221
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:376CENSUS: 233DATE:
07/27/2023
UNANNOUNCEDTIME BEGAN:
01:28 PM
MET WITH:Jeffrey ToomerTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Questionable death
INVESTIGATION FINDINGS:
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On 7/27/23, Licensing Program Analyst (LPA) M. Medina conducted a subsequent visit to deliver findings on this complaint. LPA met with Jeffrey Toomer, Executive Director and stated purpose of visit.

This Department investigated the allegation Questionable Death and based on review of records, the complaint is UNSUBSTANTIATED as the cause of R1's death was due to medical conditions.

No deficiency cited.

Exit interview conducted and a copy of this report provided for facility records.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/31/2023 and conducted by Evaluator Melinda Medina
PUBLIC
COMPLAINT CONTROL NUMBER: 24-AS-20230131153349

FACILITY NAME:BROOKDALE RIVERWALKFACILITY NUMBER:
157203395
ADMINISTRATOR:WEBSTER, REGFACILITY TYPE:
741
ADDRESS:350 CALLOWAY DRTELEPHONE:
(661) 587-0221
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:376CENSUS: 233DATE:
07/27/2023
UNANNOUNCEDTIME BEGAN:
01:28 PM
MET WITH:Jeffrey ToomerTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff did not conduct safety checks on resident after a fall
INVESTIGATION FINDINGS:
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On 7/27/23, Licensing Program Analyst (LPA) M. Medina conducted a subsequent visit to deliver findings on this complaint. LPA met with Jeffrey Toomer, Executive Director and stated purpose of visit.

The Department investigated the allegation of staff did not check on resident after a fall and based on interviews, the complaint is SUBSTANTIATED. R1 fell on 1/14/23 at approximately 6:00 PM and staff responded to R1's apartment to assist R1 however they did not conduct safety checks following the fall, which according to staff interviews, is standard procedure.

Deficiency cited on the attached 9099D for violation of Title 22, Division 6, Chapter 8, Article 08, Section 87468.2(a)(4).

Exit interview conducted. A copy of this report and appeal rights were provided.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 24-AS-20230131153349
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: BROOKDALE RIVERWALK
FACILITY NUMBER: 157203395
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/28/2023
Section Cited
CCR
87468.2(a)(4)
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87468.2 Additional Personal Rights of Residents in Privately Operated Facilities. (a)(4) To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient
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Initial staff training began on 1/17/23.
Per Executive Director additional training will be conducted with staff. An agenda will be provided to Fresno Regional Office by POC due date with
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in numbers, qualifications, and competency to meet their needs.
*This requirement was not met when R1 fell on 1/14/23, staff did not conduct safety checks which is procedure based on staff interviews.
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all staff training to be completed and submitted to Fresno Regional Office no later than 8/4/23.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Melinda HoffmannTELEPHONE: (559) 341-3247
LICENSING EVALUATOR NAME: Melinda MedinaTELEPHONE: (559) 410-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3